Eliciting key attributes of health insurance in rural India: a qualitative analysis

Low- and middle-income countries face challenges in healthcare financing, especially in the rural region. Till now, little research has been done to identify issues of the healthcare delivery system and to understand the preferences of the rural population to enrol in the health insurance scheme. This study investigates the ground-level issues intending to provide an empirical view of health insurance preferences for the population residing in the rural region. Data for the study were collected by conducting ten focus group discussions (FGD) and were analysed using grounded theory. 'Insight through participation' emerged as the core category that was generated from five categories: (1) quality-related issues; (2) governance issues; (3) design aspects; (4) financial support for healthcare services; (5) information, education and communication (IEC) activities; and other 17 subcategories. The finding highlights that quality-related issues represented the perceived poor quality of healthcare services and governance issues represented poor governance traits. The categories design aspects, financial support for healthcare services, and IEC activities define the need and the preferences of the people for health insurance. Understanding the issues of the healthcare delivery system and the consumers' preferences in the design of health insurance schemes may increase the enrolment rates.